There is now evidence to show that if you rush to get back to playing, whether as part of a team or elite sport or simply just your usual weekly recreational tennis game or jogging you may not allow the injured joint to heal fully.

Adequate recovery includes strengthening the structures the support the injured joint. This will allow joint stability to reduce risk of re-injury and stave off irreparable joint damage. If you're not careful, irreparable joint damage can eventually lead to post traumatic osteoarthritis (OA).

OA is a degenerative joint disease. It happens when the protective articular cartilage lining the surfaces of bones wear out. This causes pain, stiffness, swelling and often disability that diminishes one's quality of life.

Post traumatic OA don't just happen to older patients. It can affect adolescents or young adults too.

Researchers suggest that acute joint damage can lead to a deterioration of the surface of the bone itself and structures that cushion and stabilize bones of a joint like the knee (Anderson et al, 2012).

That same study found that OA can develop in more than 40 percent of people who seriously injure their ligaments, the meniscus in the knee or articular surface of a joint.

They also found that people with a history of knee trauma are three to six times more likely to develop knee OA.

In order to better manage post traumatic OA, a group of Athletic Trainers (ATC) has suggested a more aggressive approach to both preventing and managing post traumatic OA. Especially in younger patients who get injured playing sports.

They suggested that having less deficits (between both legs) in muscle strength, endurance, balance movement quality and stability will reduce a person's risk of getting injured. After the initial injury, it should be properly managed to prevent additional injuries to the same joint or other joints to minimize OA developing. Ideally a structured rehab program should be maintained for six to nine months.

So don't be too impatient to return to your usual physical activity especially after a joint injury. You may have to modify the activities you do in order not to place unnecessary repetitive stress on the injured joint. Remember our articular cartilage likes and needs weight bearing forces for nutrition. Inactivity will cause the articular cartilage to deteriorate.

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About Gino Ng

Prior to joining Physio Solutions and starting up Sports Solutions, Gino Ng worked as a senior sports physiotherapist at the Singapore Sports Council (SSC) from 1999-2009. He graduated with a double masters in Musculoskeletal and Sports Physiotherapy from the University of South Australia on a SSC sponsorship.

Gino's position is perhaps most unique amongst sports physiotherapists in Singapore having seen all sides of the field as a practitioner, an athlete and as a patient.

His special interests are in the treatment of articular cartilage injuries having done research in the area whilst undergoing his postgraduate training. He specializes in treating sports injuries, as well as devising sports rehabilitation programmes after reconstructive surgeries to the shoulder, knee and ankle joints.

As a former national triathlete, Gino is a 2-time Singapore National Triathlon champion (2000-2001), National Duathlon champion (2001), 10-time winner of the National Vertical Marathon (1998-2001, 2004-2005, 2007-2010). He has also placed 4th at the 2001 Asian Duathlon Championships in Hong Kong and made several podium finishes in the Asian Cup Triathlon Series events over the years while holding down a full time job as a physiotherapist.

Partly as a result of his gruelling training regime, Gino needed 3 knee surgeries in 2002 and 2003. After which he made a comeback and placed 4th in the 2005 SEA Games triathlon event.

When not participating, Gino has kept close to sports, travelling widely with the Singapore medical teams for major overseas events such as the various SEA Games, 2002, 2006 Commonwealth Games, the 2006 Asian Games and he is the only local Singaporean physiotherapist to have been to both the 2004 Athens and 2008 Beijing Olympics.

Gino is also one of only two certified Kinesio Taping Instructors (CKTI) in Singapore and teaches the Kinesio Taping Level 1, 2, 3 & 4 courses. He is also a frequent speaker at symposiums and sporting events.

While out cycling in April 2013, Gino had an accident and fractured his skull and spine. Thankfully, he is a lot better now and is back working part time. Having neck and back pain? Well, now you know who came back from a broken skull and back.